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. 1988 Apr;43(4):318–322. doi: 10.1136/thx.43.4.318

Deposition of carbenicillin aerosols in cystic fibrosis: effects of nebuliser system and breathing pattern.

S P Newman 1, G Woodman 1, S W Clarke 1
PMCID: PMC461220  PMID: 3406919

Abstract

Antibiotic aerosol treatment is successful in treating Pseudomonas infection in some patients with cystic fibrosis, but the amount of drug reaching the lungs is unknown. The deposition patterns of carbenicillin aerosols delivered from two commercially available nebuliser systems (the Turret nebuliser plus Maxi compressor and the Inspiron nebuliser plus Traveller compressor) have been compared in six patients with cystic fibrosis during tidal breathing. The aerosol mass median diameters were 3.2 and 7.3 microns. In addition, the aerosol from the Turret-Maxi nebuliser system was inhaled by a combination of tidal and deep breathing. After two minutes' breathing via a mouthpiece the mean (SEM) deposition in the lungs was 15.60 (1.5) mg carbenicillin with the Turret nebuliser plus Maxi compressor, but only 6.54 (1.09) mg with the Inspiron nebuliser plus Traveller compressor; the distribution pattern within the lung was significantly more peripheral with the former nebuliser system. These differences may be ascribed partly to the smaller droplet size from the Turret system and partly to the higher nebulisation rate from the more powerful Maxi compressor. Tidal plus deep breathing produced a further small but non-significant increase in lung aerosol deposition. A seventh patient, who failed to complete the trial, had little aerosol deposited in his lungs because he inhaled through his nose. These results emphasise the importance of correct selection of nebuliser equipment for antibiotic aerosol treatment.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Agnew J. E., Bateman J. R., Pavia D., Clarke S. W. Radionuclide demonstration of ventilatory abnormalities in mild asthma. Clin Sci (Lond) 1984 May;66(5):525–531. doi: 10.1042/cs0660525. [DOI] [PubMed] [Google Scholar]
  2. Alderson P. O., Secker-Walker R. H., Stominger D. B., Markham J., Hill R. L. Pulmonary deposition of aerosols in children with cystic fibrosis. J Pediatr. 1974 Apr;84(4):479–484. doi: 10.1016/s0022-3476(74)80664-5. [DOI] [PubMed] [Google Scholar]
  3. Asmundsson T., Johnson R. F., Kilburn K. H., Goodrich J. K. Efficiency of nebulizers for depositing saline in human lung. Am Rev Respir Dis. 1973 Sep;108(3):506–512. doi: 10.1164/arrd.1973.108.3.506. [DOI] [PubMed] [Google Scholar]
  4. Chopra S. K., Taplin G. V., Tashkin D. P., Elam D. Lung clearance of soluble radioaerosols of different molecular weights in systemic sclerosis. Thorax. 1979 Feb;34(1):63–67. doi: 10.1136/thx.34.1.63. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Dashe C. K., Ponto R. A., Ganapes C. M., Drage C. W., Kronenberg R. S. The distribution of nebulized isoproterenol and its effect of regional ventilation and perfusion. Am Rev Respir Dis. 1974 Sep;110(3):293–300. doi: 10.1164/arrd.1974.110.3.293. [DOI] [PubMed] [Google Scholar]
  6. Elliott R. B., Crossley J. R., Berryman C. C., James A. G. Partial preservation of pancreatic beta-cell function in children with diabetes. Lancet. 1981 Jul 4;2(8236):1–4. doi: 10.1016/s0140-6736(81)90249-x. [DOI] [PubMed] [Google Scholar]
  7. Elwood R. K., Kennedy S., Belzberg A., Hogg J. C., Paré P. D. Respiratory mucosal permeability in asthma. Am Rev Respir Dis. 1983 Sep;128(3):523–527. doi: 10.1164/arrd.1983.128.3.523. [DOI] [PubMed] [Google Scholar]
  8. Fleming J. S. A technique for the absolute measurement of activity using a gamma camera and computer. Phys Med Biol. 1979 Jan;24(1):176–180. doi: 10.1088/0031-9155/24/1/017. [DOI] [PubMed] [Google Scholar]
  9. Lewis R. A., Fleming J. S. Fractional deposition from a jet nebulizer: how it differs from a metered dose inhaler. Br J Dis Chest. 1985 Oct;79(4):361–367. doi: 10.1016/0007-0971(85)90069-5. [DOI] [PubMed] [Google Scholar]
  10. Littlewood J. M., Miller M. G., Ghoneim A. T., Ramsden C. H. Nebulised colomycin for early pseudomonas colonisation in cystic fibrosis. Lancet. 1985 Apr 13;1(8433):865–865. doi: 10.1016/s0140-6736(85)92222-6. [DOI] [PubMed] [Google Scholar]
  11. Newman S. P., Clarke S. W. Therapeutic aerosols 1--physical and practical considerations. Thorax. 1983 Dec;38(12):881–886. doi: 10.1136/thx.38.12.881. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Newman S. P., Pellow P. G., Clarke S. W. Choice of nebulisers and compressors for delivery of carbenicillin aerosol. Eur J Respir Dis. 1986 Sep;69(3):160–168. [PubMed] [Google Scholar]
  13. Newman S. P., Pellow P. G., Clarke S. W. Droplet size distributions of nebulised aerosols for inhalation therapy. Clin Phys Physiol Meas. 1986 May;7(2):139–146. doi: 10.1088/0143-0815/7/2/004. [DOI] [PubMed] [Google Scholar]
  14. Newman S. P., Pellow P. G., Clay M. M., Clarke S. W. Evaluation of jet nebulisers for use with gentamicin solution. Thorax. 1985 Sep;40(9):671–676. doi: 10.1136/thx.40.9.671. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Newman S. P., Woodman G., Clarke S. W., Sackner M. A. Effect of InspirEase on the deposition of metered-dose aerosols in the human respiratory tract. Chest. 1986 Apr;89(4):551–556. doi: 10.1378/chest.89.4.551. [DOI] [PubMed] [Google Scholar]
  16. Pavia D., Thomson M. L., Clarke S. W., Shannon H. S. Effect of lung function and mode of inhalation on penetration of aerosol into the human lung. Thorax. 1977 Apr;32(2):194–197. doi: 10.1136/thx.32.2.194. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Pryor J. A., Webber B. A., Hodson M. E., Batten J. C. Evaluation of the forced expiration technique as an adjunct to postural drainage in treatment of cystic fibrosis. Br Med J. 1979 Aug 18;2(6187):417–418. doi: 10.1136/bmj.2.6187.417. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Ruffin R. E., Dolovich M. B., Wolff R. K., Newhouse M. T. The effects of preferential deposition of histamine in the human airway. Am Rev Respir Dis. 1978 Mar;117(3):485–492. doi: 10.1164/arrd.1978.117.3.485. [DOI] [PubMed] [Google Scholar]
  19. Ruffin R. E., Kenworthy M. C., Newhouse M. T. Response of asthmatic patients to fenoterol inhalation: a method of quantifying the airway bronchodilator dose. Clin Pharmacol Ther. 1978 Mar;23(3):338–345. doi: 10.1002/cpt1978233338. [DOI] [PubMed] [Google Scholar]
  20. Wall M. A., Terry A. B., Eisenberg J., McNamara M., Cohen R. Inhaled antibiotics in cystic fibrosis. Lancet. 1983 Jun 11;1(8337):1325–1325. doi: 10.1016/s0140-6736(83)92428-5. [DOI] [PubMed] [Google Scholar]

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